Diagnostic Possibilities of Determining the Level of Faecal Calprotectin in Clinical Practice

Aim: to analyze the publications devoted to the modern possibilities of determining the level of faecal calprotectin (FCP) in the diagnosis of various diseases.Key points. In patients with already established diagnosis of inflammatory bowel diseases (IBD), dynamic monitoring of the level of FCP allows to assess the course and prognosis of the disease, as well as the effectiveness of treatment. The determining of FCP helps in the primary diagnosis of IBD (ulcerative colitis, Crohn's disease, microscopic colitis), contributing to their differentiation from functional bowel disorders, as well as in assessing the course of diverticular intestinal disease and celiac disease. The possibility of using FCP as a marker of colorectal cancer (CRC) and adenomatous polyps of the colon is also discussed.Conclusion. Determining the level of FCP plays an important role in the diagnosis and assessment of the course of a number of gastroenterological diseases (primarily IBD). The significance of FCP as a marker of CRC requires further research

Diet in the Management of Functional Dyspepsia: Controversial and Unresolved Issues

Аim: to analyze publications devoted to the study of the role of food in the occurrence of functional dyspepsia (FD), as well as the possibilities of using dietary nutrition in its treatment.Key findings. Many studies have shown that spicy food, food with a high content of saturated fats, coffee, carbonated drinks can lead to symptoms of FD. Intolerance to certain foods (in particular, wheat) may be associated with their ability to act as allergens. A number of studies have noted that elimination diets (a diet with a low content of FODMAP products and a gluten-free diet) reduce the severity of dyspeptic disorders, however, there is no convincing evidence of the effectiveness of these diets.Conclusion. The role of nutrition in the occurrence of FD and the possibility of using various diets in its treatment have not been sufficiently studied and require further research

Microstructure, elastic and inelastic properties of partially graphitized biomorphic carbons

The microstructural characteristics and amplitude dependences of the Young's modulus E and internal friction (logarithmic decrement delta) of biocarbon matrices prepared by beech wood carbonization at temperatures T (carb) = 850-1600A degrees C in the presence of a nickel-containing catalyst have been studied. Using X-ray diffraction and electron microscopy, it has been shown that the use of a nickel catalyst during carbonization results in a partial graphitization of biocarbons at T (carb) a parts per thousand yen 1000A degrees C: the graphite phase is formed as 50- to 100-nm globules at T (carb) = 1000A degrees C and as 0.5- to 3.0-mu m globules at T (carb) = 1600A degrees C. It has been found that the measured dependences E(T (carb)) and delta(T (carb)) contain three characteristic ranges of variations in the Young's modulus and logarithmic decrement with a change in the carbonization temperature: E increases and delta decreases in the ranges T (carb) 1300A degrees C; in the range 1000 < T (carb) < 1300A degrees C, E sharply decreases and delta increases. The observed behavior of E(T (carb)) and delta(T (carb)) for biocarbons carbonized in the presence of nickel correlates with the evolution of their microstructure. The largest values of E are obtained for samples with T (carb) = 1000 and 1600A degrees C. However, the samples with T (carb) = 1600A degrees C exhibit a higher susceptibility to microplasticity due to the presence of a globular graphite phase that is significantly larger in size and total volume.Rusia, Russian Foundation for Basic Research project no. 14-03-00496Presidium of the Russian Academy of Sciences program no. P-20España, Junta de Andalucia grant no. P09-TEP-515

Structural imaging findings are related to clinical complications in chronic pancreatitis

Background/objectives: Structural pancreatic changes and complications related to chronic pancreatitis are well described, but little is known about their relationship. We aimed to explore the associations between pancreatic morphology and clinical complications in a large chronic pancreatitis cohort. Methods: The Scandinavian Baltic Pancreatic Club database collects registrations on patients with definite or probable chronic pancreatitis according to the M-ANNHEIM diagnostic criteria. In this cross-sectional study, we used multivariate logistic regression analyses to evaluate whether imaging-based structural pancreatic changes were associated with common clinical complications. We adjusted for sex, age, disease duration, current alcohol abuse and current smoking. Results: We included 742 patients with a mean age of 55 years. Among these, 68% were males, 69% had pancreatic exocrine insufficiency, 35% had diabetes, 12% were underweighted and 68% reported abdominal pain. Main pancreatic duct obstruction, severe (i.e. more than 14) calcifications, pancreatic atrophy and parenchymal changes throughout the entire pancreas (continuous organ involvement) were positively associated with pancreatic exocrine insufficiency. Continuous organ involvement and pseudocysts were positively and negatively associated with diabetes, respectively. Pancreatic atrophy and severe calcifications were positively associated with underweight, and severe calcifications were negatively associated with pain. Conclusions: This study shows independent associations between distinct structural changes on pancreatic imaging and clinical complications in chronic pancreatitis. Pancreatic atrophy, severe calcifications and continuous organ involvement may be of particular clinical relevance, and these findings should motivate monitoring of pancreatic function and nutritional status.publishedVersio

Clinical Guidelines of the Russian Society of Surgeons, the Russian Gastroenterological Association, the Association of Surgeons-Hepatologists and the Endoscopic Society “REndO” on Diagnostics and Treatment of Chronic Pancreatitis

Aim: to present modern methods of diagnosis and treatment of chronic pancreatitis for gastroenterologists, general practitioners and physicians.Chronic pancreatitis (CP) is a long-term inflammatory disease of the pancreas, manifested by irreversible morphological changes in the parenchyma and pancreatic ducts, which cause pain and/or persistent impairment of function. Current concept on the etiology of CP is reflected by the TIGAR-O classification. The criteria for establishing the diagnosis of CP include typical attacks of abdominal pain and/or clinical and laboratory signs of exocrine, endocrine insufficiency with the mandatory detection of characteristic morphological changes (calcifications in the parenchyma and pancreatic ductal stones, dilatation of the main pancreatic duct and its branches). CT, MRCP, and pancreatobiliary endosonography are recommended as the methods of choice to verify the diagnosis of CP. Conservative treatment of patients with CP is provided for symptom relief and prevention of complications. Individual cases with severe non-interactable abdominal pain, as well as a complicated course of the disease (development of ductal hypertension due to main pancreatic duct stones or strictures, obstructive jaundice caused by compression of the common bile duct, symptomatic postnecrotic cysts, portal hypertension due to compression of the portal vein or thrombosis of the splenic vein, persistent duodenal obstruction, pseudoaneurysm of the celiac trunk basin and the superior mesenteric artery) serve as an indication for endoscopic or surgical treatment. The Guidelines set out modern approaches to the diagnosis, conservative, endoscopic and surgical treatment of CP, and the prevention of its complications.Conclusion. The implementation of clinical guidelines can contribute to the timely diagnosis and improve the quality of medical care for patients with chronic pancreatitis

Current Potential of Pantoprazole in Treatment and Prevention of Gastrointestinal Diseases

Aim. An outline of the current potential of pantoprazole in treatment and prevention of upper gastrointestinal diseases.Key points. Pantoprazole is widely applied in gastroesophageal reflux, peptic ulcer disease, Zollinger—Ellison syndrome and for Helicobacter pylori eradication. It minimally inhibits the CYP2C19 isoenzyme involved in the metabolism of many drugs. Pharmacokinetics of pantoprazole conditions a weaker drug interaction compared to other proton pump inhibitors (PPIs), which enables its use for gastrointestinal bleeding prevention in patients receiving dual antiplatelet therapy. The new coronaviral pandemic of COVID-19 urges the selection of PPIs that minimise the drug interference, such as pantoprazole, in therapy and prevention of acid-related upper gastrointestinal diseases. Pantoprazole has a good tolerance and low side effect rate.Conclusion. Pantoprazole is considered among optimal PPIs for efficacy, safety and adherence on the basis of clinical trials for treatment and prevention of gastrointestinal diseases, systematic reviews and meta-analyses

First Russian Gastroenterology Olympiad

On October 21, 22, 23, 2022, within the framework of the 122nd International Session of the National School of Gastroenterology, Hepatology (NSGH) of the Russian Gastroenterological Association (RGA), the First Russian Gastroenterology Olympiad was held

Efficacy of Trimebutine Maleate (Trimedat®) in the Treatment of Patients with Functional Dyspepsia: Results of the “TREND” Observational Study

Aim. This research is aimed at investigating the experience of applying trimebutine maleate in the daily practice of physicians managing patients with functional dyspepsia syndrome (FDS).Materials and methods. The study included 100 patients diagnosed with FDS. The patients were asked to complete a 7 × 7 and SF36 questionnaires before and on the 7th, 14th, 28th days of treatment. The treatment was performed using trimebutine (Trimedat®) in a standard dosage of 200 mg × 3 times a day for 28 days.Results. In the group under study, 45 (45 %), 3 (3 %) and 52 (52 %) patients suffered from epigastric pain syndrome (EPS), postprandial distress syndrome (PPDS) and a combination of both syndromes, respectively. The combination of FDS with gastroesophageal reflux disease (GERD) was noted in 15 patients (15 %). Irritable bowel syndrome (IBS) was present in 21 cases (21 %). Trimebutine maleate (Trimedat®) has been proven effective in all FDS forms, such as EPS, PPDS and their combination. In the course of treatment, the average score of the patients’ physical and mental health increased from 48.02 ± 5.62 to 52.97 ± 4.17 points (p &lt; 0.0001), and from 48.48 ± 10.83 up to 51.79 ± 8.51 points (p &lt; 0.0001), respectively.Conclusion. The main clinical forms of functional dyspepsia syndrome (EPS and PPDS) are frequently manifested in combination either with each other (52 %), or with IBS (21 %) and GERD (15 %). The use of trimebutine in the treatment of patients with FDS is shown to result in a decrease in the severity of its main symptoms and a reliable increase in the quality of patients’ life